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https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#1
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28439419/chronic-complications-and-quality-of-life-of-patients-living-with-sickle-cell-disease-and-receiving-care-in-three-hospitals-in-cameroon-a-cross-sectional-study
#2
Anne M Andong, Eveline D T Ngouadjeu, Cavin E Bekolo, Vincent S Verla, Daniel Nebongo, Yannick Mboue-Djieka, Simeon-Pierre Choukem
BACKGROUND: Sickle Cell Disease (SCD) is associated with chronic multisystem complications that significantly influence the quality of life (QOL) of patients early in their life. Although sub-Saharan Africa bears 75% of the global burden of SCD, there is a paucity of data on these complications and their effects on the QOL. We aimed to record these chronic complications, to estimate the QOL, and to identify the corresponding risk factors in patients with SCD receiving care in three hospitals in Cameroon...
2017: BMC Hematology
https://www.readbyqxmd.com/read/28438262/hair-follicle-transplant-into-chronic-ulcers-a-new-graft-concept
#3
M L Martínez Martínez, E Escario Travesedo, F Jiménez Acosta
Chronic venous leg ulcers are a major therapeutic challenge in clinical practice, and the search for new approaches to improve wound healing is essential. Many ulcers do not heal with traditional treatment using compression, debridement, and dressings. Skin-grafts variants, such as pinch grafts, punch grafts, split- or full-thickness skin grafts, and grafts derived from cells cultured in the laboratory, are among the most widely used options in ulcers that do not heal. In recent years, numerous studies have brought to our attention the important role of the hair follicle in the healing process of cutaneous wounds...
April 21, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/28434731/a-prospective-cohort-study-of-digital-cushion-and-corium-thickness-part-2-does-thinning-of-the-digital-cushion-and-corium-lead-to-lameness-and-claw-horn-disruption-lesions
#4
R F Newsome, M J Green, N J Bell, N J Bollard, C S Mason, H R Whay, J N Huxley
The aim of this study was to determine whether a decrease in thickness of the sole soft tissues (SST) beneath the flexor tuberosity of the distal phalanx (i.e., the digital cushion and corium) predisposed a claw to develop claw horn disruption lesions (CHDL) or a leg to lameness. Data were analyzed from a longitudinal study of 179 cows, which had been examined at 5 assessment points -8, +1, +9, +17, and +29 wk relative to their first, second, third, or fourth calving. At each assessment point, SST were measured using ultrasonography...
April 20, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28424334/glycosaminoglycan-based-hydrogels-capture-inflammatory-chemokines-and-rescue-defective-wound-healing-in-mice
#5
Nadine Lohmann, Lucas Schirmer, Passant Atallah, Elke Wandel, Ruben A Ferrer, Carsten Werner, Jan C Simon, Sandra Franz, Uwe Freudenberg
Excessive production of inflammatory chemokines can cause chronic inflammation and thus impair cutaneous wound healing. Capturing chemokine signals using wound dressing materials may offer powerful new treatment modalities for chronic wounds. Here, a modular hydrogel based on end-functionalized star-shaped polyethylene glycol (starPEG) and derivatives of the glycosaminoglycan (GAG) heparin was customized for maximal chemokine sequestration. The material is shown to effectively scavenge the inflammatory chemokines MCP-1 (monocyte chemoattractant protein-1), IL-8 (interleukin-8), and MIP-1α (macrophage inflammatory protein-1α) and MIP-1β (macrophage inflammatory protein-1β) in wound fluids from patients suffering from chronic venous leg ulcers and to reduce the migratory activity of human monocytes and polymorphonuclear neutrophils...
April 19, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28421746/multifunctional-enzymatically-generated-hydrogels-for-chronic-wound-application
#6
Ivaylo Stefanov, Sílvia Pérez-Rafael, Javier Hoyo, Jonathan Cailloux, Orlando O Santana Pérez, Dolores Hinojosa-Caballero, Tzanko Tzanov
The healing of chronic wounds requires intensive medical intervention at huge healthcare costs. Dressing materials should consider the multifactorial nature of these wounds comprising deleterious proteolytic and oxidative enzymes and high bacterial load. In this work, multifunctional hydrogels for chronic wound application were produced by enzymatic cross-linking of thiolated chitosan and gallic acid. The hydrogels combine several beneficial to wound healing properties, controlling the matrix metalloproteinases (MMPs) and myeloperoxidase (MPO) activities, oxidative stress, and bacterial contamination...
April 25, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28414665/a-case-of-early-neurosyphilis
#7
M Walker, R Wisler, J Simmons, A Johnson
INTRODUCTION: Neurosyphilis is an infection of the central nervous system by Treponema pallidum, which can occur after the initial syphilis infection. Although commonly associated with late stage disease, patients with early neurosyphilis may present with acute syphilitic meningitis, meningovascular syphilis, or uveitis. CASE: A 28 year old man with a past medical history of HIV (CD4 364);, and recent diagnosis of uveitis presented to the Emergency Department with a positive RPR result...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28408089/mid-term-outcomes-of-endovenous-laser-ablation-in-patients-with-active-and-healed-venous-ulcers-a-follow-up-study
#8
H Sinabulya, R Östmyren, L Blomgren
OBJECTIVES: The aim of this study was to assess the mid-term ulcer recurrence rate in patients with healed or active venous ulcers treated with endovenous laser ablation (EVLA) for incompetent superficial axial veins and to search for possible risk factors for non-healing and recurrence. METHODS: Consecutive patients treated with EVLA because of a healed or active venous ulcer between 2006 and 2013 were identified in the medical records and quality registry and invited to follow-up, including clinical history, study examination, Duplex ultrasound scanning, ankle brachial pressure, photoplethysmography, venous clinical severity score (VCSS), and health related quality of life (HRQoL) measured with EQ5D...
April 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28400399/cardiotoxicity-with-itraconazole
#9
Vishesh Paul, Harsh Rawal
Itraconazole is a commonly used antifungal drug. In addition to commonly described adverse effects, there have been few reports of heart failure with its use. We present two cases that developed acute systolic heart failure with Itraconazole use. A man in his early 30s was admitted with worsening leg swelling and dyspnoea on exertion. He had been on Itraconazole for blastomyces skin ulcer. His ejection fraction (EF) was found to be 10%-15%. Another man in his 50s was admitted with similar symptoms; his EF was 40%-45%...
April 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28387882/enzymatic-debridement-is-ha-collagenase-the-right-synergy-randomized-double-blind-controlled-clinical-trial-in-venous-leg-ulcers
#10
A Scalise, F Campitiello, A Della Corte, P Longobardi, M Di Salvo, C Tartaglione, C Santin, N Giordan, G Guarnera
OBJECTIVE: The aim of this study is to evaluate the efficacy and safety of a new ointment containing Hyaluronic Acid and collagenase from non-pathogenic Vibrio alginolyticus. PATIENTS AND METHODS: Double blind, multicenter, controlled clinical trial (no. ISRCTN71239043) conducted to demonstrate the superiority of Hyaluronic Acid-Collagenase applied once a day over placebo in mean reduction of devitalized/fibrinous/slough tissue after 15 days of treatment. 113 patients with venous ulcers were enrolled and randomized to receive active treatment therapy or vehicle preparation...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28384224/socio-environmental-exposures-and-health-outcomes-among-persons-with-sickle-cell-disease
#11
Monika R Asnani, Jennifer Knight Madden, Marvin Reid, Lisa-Gaye Greene, Parris Lyew-Ayee
There is much variability in the expression of sickle cell disease (SCD) and recent works suggest that environmental and social factors may also influence this variability. This paper aims to use geographic information systems technology to examine the association between socio-environmental exposures and health outcomes in all persons who have attended or currently attend the Sickle Cell Unit in Jamaica. Rural patients presented for clinical care at older ages and had less annual visits to clinic. Persons travelled relatively long distances to seek SCD care and those travelling longer had less health maintenance visits...
2017: PloS One
https://www.readbyqxmd.com/read/28379102/cost-of-illness-studies-in-chronic-ulcers-a-systematic-review
#12
B Chan, S Cadarette, W Wodchis, J Wong, N Mittmann, M Krahn
OBJECTIVE: To systematically review the published academic literature on the cost of chronic ulcers. METHODS: A literature search was conducted in MEDLINE, EMBASE, HealthSTAR, Econlit and CINAHL up to 12 May 2016 to identify potential studies for review. Cost search terms were based on validated algorithms. Clinical search terms were based on recent Cochrane reviews of interventions for chronic ulcers. Titles and abstracts were screened by two reviewers to determine eligibility for full text review...
April 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28369771/intervention-radiology-for-venous-thrombosis-early-thrombus-removal-using-invasive-methods
#13
REVIEW
Ana I Casanegra, Robert D McBane, Haraldur Bjarnason
The post thrombotic syndrome is one of the most dreaded complications of proximal deep vein thrombosis. This syndrome leads to pain and suffering with leg swelling, recalcitrant ulceration and venous claudication which greatly impairs mobility and quality of life. The prevalence can be high in patients with iliofemoral venous involvement particularly in the setting of a proximal venous stenosis, such as occurs in May Thurner syndrome. Anticoagulation alone does not reduce the likelihood of this outcome. Compression therapy may be effective but garment discomfort limits its implementation...
April 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28355140/pretibial-myxedema-masquerading-as-a-venous-leg-ulcer
#14
Ingrid Herskovitz, Olivia Hughes, Flor MacQuhae, Robert S Kirsner
The authors report a case of pretibial myxedema (PTM) masquerading as a venous leg ulcer to alert wound care clinicians to this diagnostic possibility. Pretibial myxedema is a localized form of mucin cutaneous deposition characterized by indurated plaques most commonly on anterior legs. It is more likely to present in patients with Graves' disease, but it can be found in euthyroid patients as well. The physiopathology of PTM is complex, and there is an accumulation of highly hydrophilic glycosaminoglycans in the dermis...
March 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28353459/first-report-of-kocuria-marina-bloodstream-infection-unrelated-to-a-central-venous-catheter-a-mini-review-on-an-emerging-and-under-recognized-opportunistic-pathogen
#15
Giovanna Pulcrano, Michela Balzaretti, Alessia Grosini, Vincenzo Piacentini, Dimitri Poddighe
We report a case of sepsis by Kocuria marina in a 45-year-old woman carrying a midline venous catheter to provide total parenteral nutrition. Despite the finding of K. marina bacteraemia, no bacteria grew from the culture of the catheter tip. As the patient was affected with severe leg ulcers, K. marina bloodstream infection from a skin breakage other than CVC was supposed. K. marina is an emerging opportunistic agent deserving attention and probably under-recognized, as it can be misdiagnosed as Staphylococcus if only conventional microbiological analyses are performed for bacterial identification...
March 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28342202/treatment-of-chronic-venous-ulcers-experience-in-six-patients-treated-with-terminal-interruption-of-the-reflux-source-tirs
#16
M Mendieta-Eckert, J L Azpiazu-Macho, R Lambea-Crespo
Venous leg ulcers (VLU) are the latest manifestation of chronic venous insufficiency (CVI) and the leading cause of chronic leg ulcers. Compression therapy is considered the main treatment. Unfortunately, they require long-term treatment to cure and have a high rate of recurrence (up to 78%). (1,)(2) This article is protected by copyright. All rights reserved.
March 25, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28329467/unna-boot-central-gauze-technique-for-chronic-venous-leg-ulcers
#17
Anne L Gao, Justin G Cole, William V Stoecker
BACKGROUND: Venous leg ulcers generally take manyweeks to heal. Novel therapies that shorten healingtime and require less complex care are needed. PURPOSE: The purpose of this report is to presenta pilot study for a new method that can result ina faster healing time for venous leg ulcers usinginexpensive materials. METHODS: A central-gauzeprotocol was developed as described here. A three-ply gauze sponge was placed in the center of theulcer, allowing a peripheral 3-5 mm rim of ulcer toremain exposed...
January 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28321316/pre-operative-urinary-tract-infection-is-it-a-risk-factor-for-early-surgical-site-infection-with-hip-fracture-surgery-a-retrospective-analysis
#18
Rafik Rd Yassa, Mahdi Y Khalfaoui, Karunakar Veravalli, D Alun Evans
OBJECTIVE: The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections. DESIGN: A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data...
March 2017: JRSM Open
https://www.readbyqxmd.com/read/28320360/a-prospective-analysis-of-pinch-grafting-of-chronic-leg-ulcers-in-a-series-of-elderly-patients-in-rural-cameroon
#19
Benjamin Momo Kadia, Christian Akem Dimala, Desmond Aroke, Cyril Jabea Ekabe, Reine Suzanne Mengue Kadia, Alain Chichom Mefire
BACKGROUND: Chronic leg ulcers (CLUs) pose serious public health concerns worldwide. They mainly affect the elderly population. Pinch grafting (PG) could be used to treat a variety of CLUs. However, in Cameroon, there is scarce data on the outcome of PG of CLUs in elderly patients in rural hospitals where most of these patients seek for medical attention and where clinicians rely on unconventional wound dressing methods to treat CLUs. Our objective was to describe the outcome of PG of CLUs in elderly patients in rural Cameroon...
March 20, 2017: BMC Dermatology
https://www.readbyqxmd.com/read/28319279/borderline-lepromatous-leprosy-erythema-nodosum-leprosum-and-a-generalized-varicella-zoster-virus-infection
#20
Cornelis Kennedy, Bernard Naafs
We report the case of a thirty-year-old man with Mid-Borderline (BB) to Borderline Lepromatous Leprosy (BL) who was admitted to the hospital with blistering lesions on his upper and lower extremities. These lesions, which were partly filled with pus rapidly developed into erosions and ulcerations with hemorrhagic crusts. Other observations at time of admission included a tender erythematous plaque on his forehead, a drop foot on the right leg, muscle atrophy in both hands, a low grade fever, and pain and swelling in his right lower jaw...
March 20, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
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